Objective To explore the surgical management and its results of intercondylar fracture of humerus through approach of extra-articular oblique osteotomy of olecranon. Methods From March 1995 to October 2003, 26 patients of intercondylar fracture of humerus were treated surgically through approach of extra-articular oblique osteotomy of olecranon, and the fracture was reduced and fixed with "8" steel wire. The patients were 15 men and 11 women with a mean age of 43.2 years (range 19-68 years). 14 fractures occurred on the left extremity and 12 on the right. The fractures resulted from traffic accident or fall in 23 and other trauma in 3. According to AO/ASIF classifation, type C1 fracture was found in 3, C2 in 5 and C3 in 18. 5 patients suffered open fracture(Custilo scaleⅠin 3, and Ⅱ in 2). Contusion of skin occurred in 3 and multiple injuries in 5, while primary injury of ulnar nerve occurred in 4. The rehabilitation exercises began at 2-7 d post-operatively. The healing of the osteotomy was evaluated with physical examination and plain X-ray film, and the function of elbow was assessed according to Cassebaum scale. Results 21 patients were followed from 9 months to 8 years(average, 18 months). Of these 21 cases, all the osteotomies healed in 6.2 weeks averagely, no nonunion, delayed union, separation or malunion was found. Heterotopic ossification occurred in 4 cases, and obviously limited locomotion of elbow in 2. Of the 4 patients with primary injury of ulnar nerve, no breaking was found during exploration, and the nerve was displaced anteriorly. 3 of these 4 patients recovered completely, and mild sensory disturbance and dyskinesis remained in 1. The function of the elbow showed excellent in 12, good in 6, fair in 1 and poor in 2. The locomotion of the elbow averaged 110?. Conclusion The use of the approach of extra-articular oblique osteotomy of olecranon for surgical management of intercondylar fracture of humerus has many advantages, it provides satisfactory stability with simple technical procedure avoiding intra-articular invasion, it facilitates rehabilitation exercises and provides good results with low complication rate.

[Objective]To investigate the treatment of nonunion after Pilon fracture with fibula approach fixation of tibia and ankle joint fixation and its clinical efficacy.[Method]Six cases of nonunion after Pilon fracture were collected from 1999 to 2004,which included 4 males and 2 females,with the average age of 34.7 years(21~53 years).All fractures were found invasion to the tibia-fibula joint and ankle malformation.Fibula and tibia were opened from posterolateral approach and reconstruction plate was placed laterally on the fibula,with screws crossing the fibula into the tibia directly.Autogenous bone graft was used in fracture position and area between tibia and fibula to gain tibia-fibula fusion.[Result]All cases were followed up from 8 months to 4 years with the average of 22 months.Bone fusion were gained in 5 cases with the average time of 3.5 months.Plate broken was found in 1 case for too early weight bearing.[Conclusion]Fibula approach fixation of tibia and ankle joint fixation has advantages of promoting fracture healing,preventing complications,and correction joint malformation.It is a convenient and reliable method for clinical surgeons.

Objective To study the effect of data envelopment analysis evaluation on nursing efficiency in general hospitals.Method The input indexes including the number of enrolled nurse,indirect nursing time,average annual nursing consumables and average annual continuing education time and the output indexes including hospitalized patient number and year-round nursing income of 10 nursing units in our hospital during October 2012 to October 2013 were collected and analyzed with C2R,C2GS2 model and C2R/ C2GS2 ratio from Data Envelopment Analysis.Result About 5 nursing units were effective in terms of overall efficiency,8 ones in terms of unit technical efficiency and 5 one in terms of nursing unite scale efficiency.Conclusions We need improve nursing efficiency in our hospital.Nursing managers should pay attention to the results and improve working process aiming at the practical situations.

[Objective]To summarize the experience about treatment of segmental and comminuted femoral fractures with intramedullary nail in multiple injuries.[Method]From March 2002 to July 2006,28 patients with segmental and comminuted femoral fractures were treated surgically,13 with AO type C1,9 with C2 and 6 with C3.All of the fractures were treated with close reduction static intramedullary nail fixation.[Result]The postoperative follow-up ranged from 11 to 34 months with an average of 21 months.All of the fractures were healed.Limit load was required for 5 patients who had delayed union without special treatment.After 18-30 months the patients healed up.There were no fat embolisms.No complications such as infection,intramedullary bending or break occurred.[Conclusion]Treatment of femoral fractures with intramedullary nail is a standard method.However,to achieve satisfactory results,comprehensive treatment,careful planning and procedure should be taken for segmental and comminuted femoral fractures in multiple injuries.

Objective: To observe the clinical disinfection effect of root canal with non-filling medication. Methods: 36 patients who required root canal therapy(RCT) for apical periodontitis (acute or chronic) or pulp necrosis were involved in the study.RCT was completed after two visits in both groups. Non-filling medication was used as disinfection in 18 teeth of 18 patients (experimental group) while FC in another 18 teeth of 18 patients (control group) randomly at first visit.One week later,root canal was regularly filled to complete RCT.From each case, bacteria specimens were collected and identified before sealing and filling. Results: Bacteria were detected in every specimen in both groups before sealing,which were mixture of aerobes and anaerobes.One week later,only one strain was detected in one specimen of each group. Conclusion: Non-filling medication can be used as an effective disinfection to sterilize root canal.

Objective To investigate the diagnostic value of a fast gradient-echo(GRE) three-dimensional contrast-enhanced volumetric interpolated breath-hold examination(3D-VIBE) MR sequence in evaluating focal liver lesions.Methods Conventional spin-echo T2W,2D GRE T1W plain scan and Gd-enhanced 3D-VIBE multi-phasic(early arterial,late arterial and portal venous phases) acquisitions were prospectively performed for 51 consecutive patients suspected of having focal liver lesions on CT or ultrasound imaging.Native T2W and 2D GRE T1W were acquired first,then 3D-VIBE fast scanning at early arterial,late arterial and portal venous phases respectively.The SNR and CNR of the liver lesions on plain scan and the enhancement patterns on contrast-enhanced 3D-VIBE images were carefully observed with correlation of the clinical and surgical pathological findings.Results There exited certain differences in SNR,CNR,and the enhancement patterns of different kinds of focal hepatic lesions in plain scan and Gd-enhanced multi-phasic 3D-VIBE acquisitions.Conclusion 3D-VIBE MR sequence is helpful in the detection and characterization of focal liver lesions.

Objective To study the effects of prenatal exposure to low level lead on the physical and neuro-behavioral development of mice and the interaction between lead and zinc. Methods Kunming pregnant mice were provided with drinking water containing lead, zinc and lead-zinc jointly and respectively. The body weight of maternal mice, offspring's survival rate and body weight were observed. Neuro-behavioral development of offspring was assessed by observation of offspring's behavior performance. The levels of dopamine (DA), 5-hydroxytryptamine (5-HT) and malonaldehyde (MDA) in offspring's brains were measured. Results At the doses of lead and zinc which did not effect the increase of maternal body weight during pregnancy, the lead exposure group showed low survival rate, growth retardation and delay of physiological development and neonatal reflexes in the offspring, the levels of DA and MDA in offspring's brains increased compared with the control group. Offspring's low survival rate and growth retardation couldn't be antagonized by zinc, but equal mole as lead of zinc could inhibit the harmful effects on neuro-reflex development. Zinc could also inhibit the increase of DA and MDA levels in offspring's brains induced by lead . However joint exposure to lead and half dosage as much as lead of zinc could deteriorate the effects on delay of physical, neuro-behavioral development and accelerate the DA and 5-HT decompose compared with that in the lead exposure group. Conclusion The harmful effects on offspring's growth and neuro-behavioral development could be induced by prenatal exposure to low level of lead. The types of joint-effect of lead and zinc were different according to the concentration of zinc, which indicated that the zinc-lead interaction was very complicated and it should be very prudent to antagonize lead toxicity using zinc.

Objective To investigate the CT imaging features of metastatic hepatic adenocarcinomas from the digestive tract by using multi-detector-row helical CT (MDCT) with pathological correlation. Methods CT and clinical data of 36 patients with pathologically proven metastatic hepatic adenocarcinomas from the digestive tract were retrospectively reviewed. The primary tumors included 10 cases of gastric cancer, 1 duodenal cancer, 18 colo- nic carcinoma, 7 rectal cancer. All patients underwent MDCT plain scan and contrast-enhanced dual-phase scanning of upper or whole abdomen. The appearances of hepatic metastatic lesions on MDCT images at various enhancement phases were carefully observed. Results On plain CT scan 32 cases (88.9%) presented multiple nodules of low density at different sizes, 3 cases (8.3%) showed a single low-density nodule, and 1 case presented with a cystic mass. On contrast-enhanced scan, 4 cases (11.1%) showed faintly enhanced rim around the nodules on arterial phase; on portal venous phase 29 cases (80.6%) presented slight ring-like enhancement at the periphery of the nodule while the nodule core was markedly hypodense with intermediate soft tissue density area in between, giving rise to the typical appearance of “bull’s-eye” sign. Three cases (8.3%) showed no enhancement on either phase images. Conclusion The ring-like enhancement and the appearance of “bull’s-eye” on portal venous phase was characteristic CT features of metastatic hepatic adenocarcinoma from digestive tract.

Objective: To observe the influences of Dengzhan Xixin injection(灯盏细辛注射液) on(vascular) endothelial function and neurological deficit extent in patients with acute cerebral infarction.(Methods): Eightyseven patients with mild to moderate acute cerebral infarction were randomly(divided) into Dengzhan Xixin injection treatment group(treatment group,42 cases) and control group(45 cases) by the random method of envelope and card.The patients in both groups were treated with the same basic therapy.The treatment group was treated with 40 ml of Dengzhan Xixin injection,and the control group was treated with 16 ml of salvia miltiorrhiza injection.The therapeutic course was 14 days in both groups and 2 courses were applied.The changes of circulating endothelial cell count(CEC),the levels of endothelin(ET) and(calcitonin) generelated peptide(CGRP) in plasma as well as neurological deficit were measured and(compared).Results: The plasma CEC,ET in treatment group((8.0?3.6)cells/0.9 ?l and(52.92?(4.52)ng/L)) were significantly lower than those in control group((10.2?3.3)cells/0.9 ?l and(60.12?(3.23)ng/L)),but the plasma CGRP was higher than that in the(control) group on 14 th days((65.23?(1.52)ng/L) vs.(60.12?2.14)ng/L).The differences were significant between the two groups(P

Objective To explore the effectiveness of monitoring for developmental delay (DD) and the feasibility of firsthand data reporting among 0~3 years old children. Methods A study population consisted of a cluster sample of 20907 children aged 0~3 years, from 22 communities in 5 districts in Beijing, was monitored for 1 year using questionnaires and data reports. The results were compared against the non-project communities. Results The screening rate of DD was 62.18%, higher than the non-project groups, and the rate of 0 year old group was significantly higher than the other groups. 268 children were positive screening, referral of 253 children, the referral rate was 94.4%; 97 children were diagnosed as DD with the prevalence rate of 7.46 ‰; 43.28% of the children received intervention and rehabilitation training. Conclusion The surveillance means of DD for 0~3-year-old children are effective and the firsthand data report is feasible